1992, 02-18 Permit App: 92000864 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM 9 2 E3&(
Information Worksheet (o3
JOB STREET ADDRESS: 4 . 7 % 13 S, RiV_e. r Z,,, A. `1
CITY/STATE/ZIP: Shoo/C" ii /•ulL . PARCEL NUMBER:
OWNER: L .e. 1 70.- n L.. E 4. PHONE NUMBER: 7-2 7-. C. 7.2 9
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: AIRE VALLEY HEATING & cooling- LICENSE NUMBER: AIREVHI1410H
PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA 99212
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSE T
GAS WATER HEATER
........................................................................................................................
GAS EQUIPMENT <100,0 BTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
...........................................................................
GAS PIPING (EA OUTLET).... . .
BOILER/REFRIG 1-100M BTU
E01LERI1EFIGO:500M
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG:.1.0001.
BOILER/REFRIG +1,750M BTU
HEAT PUMP AIR CONDITIONER' ,-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
NEAT PUMP & AIR CONDITIONER •15 30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
NEAT PUMP &..AIR CONDITIONER +50•
:TONS.....
VENTILATING FANS
ARQRATty000Qtx
.........................................................................................................................
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
............................................................................................................
MISCELLANEODUS (NOT COVERED ELS HE;
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS;APPLIANCE>400 000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIA iCE >400,000
AIR HANDLER <10,000 CFM
AI t HANDLE>1
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x12.00=
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x25.00 =
x35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/ e' °1/4=-
l
4..2 "..'=-"-
.2.__
.l '•
• •
SUBTOTAL
$ y (.:!--
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 4'9. 00
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675